Doctors and therapists often need to position a patient's arm, particularly after surgery or stroke. Foam arm elevators have been used to elevate the affected upper extremity of a wheelchair bound patient in order to prevent swelling in that extremity, especially in the hand and wrist. Arm elevators also have been used to prevent unnecessary motion of the patient's arm, which can lead to painful bruising or subluxation.
Many stroke victims suffer hemiplegia, coupled with sensory loss to the affected side. The patient is often unable to detect long periods of pressure or contact with sharp objects which may cause bruising or even cutting fragile skin, particularly for elderly individuals or individuals medicated with blood thinning agents.
For a patient with limited shoulder musculature, such as occurs with paralysis after a stroke, movement of the patient's elbow down or away from the body can cause shoulder subluxation, the separation of the head of the humerus from the glenohumeral joint, which is often accompanied by pain. Current devices are not always stable and may move, causing elbow movement as well. As the elbow moves away from the trunk of the seated patient, support of the head of the humerus in the glenohumeral joint decreases.
Existing arm elevators must rest on a supporting or securing device, typically a relatively wide surface such as a lap tray, a half-lap tray, or plastic supporting device designed to receive the arm elevator. See North Coast Medical, Inc. 1993 ADL Catalog, Item NC94133 on page 112. Some such supporting devices are designed with vertical portions to form a bounded tray so the arm elevator cannot slip off. See North Coast Medical, Inc. 1993 ADL Catalog, Items NC96560 and NC94108 on page 105. Some such devices can be adjusted to a selected height or angle. The supporting or securing items are an additional expense required in order to use an arm elevator with a wheelchair.
Foam arm elevators are presently in high demand throughout the therapy industry due to their comfort for patients and the minimal risk they pose for causing skin breakdown (decubiti). The inexpensive material (foam) makes the item disposable.
Existing arm elevators do not provide a wholly satisfactory solution to some of the problems mentioned above. Existing arm elevator devices simply rest on a lap tray, often resulting in shifting of the foam. Many of the existing arm elevator devices can put unnecessary pressure on a patient's skin and cause bruising. Many of the existing arm elevator devices are relatively thin. If such a device is placed on a thick tray or support it will provide a certain height for a patient's shoulder, but when placed on a different tray will provide a different shoulder height. A consistent and desirable height would be preferred to the range of heights for current arm elevators.
Current securing devices are generally constructed from plastic or other rigid materials, each of which are designed to fit only a limited number of chairs, resulting in poor or inconsistent fits to the variety of wheelchair armrest shapes and sizes on the market. A more adaptable arm elevator device would eliminate these inconsistencies.